Multiple Sclerosis Diagnosis in Adolescents by 2017 McDonald Criteria: Two Case Reports
DOI:
https://doi.org/10.46531/sinapse/CC/210059/2022Keywords:
Adolescent, Multiple Sclerosis/diagnosis, Multiple Sclerosis/diagnostic imagingAbstract
Although multiple sclerosis’ (MS) diagnosis is usually made in adulthood, clinical presentation before the age of 18 occurs in up to 10% of the individuals. McDonald’s criteria applicability in diagnosing MS in adolescents is already established with the 2010 revision. The first clinical case we present is an adolescent with a family history of MS and a right retrobulbar optic neuritis’ presentation. Magnetic resonance imaging revealed periventricular and infratentorial lesions white matter lesions. The second case describes an adolescent with a suggestive presentation of acute transverse myelitis, with a sensitive level in D10 and multiple brain and spinal inflammatory lesions. Cerebrospinal fluid oligoclonal bands were present in both patients. Both met the 2017 McDonald criteria for MS diagnosis. MS diagnosis is particularly difficult in children and adolescents. A high degree of suspicion is needed. Differential diagnosis with other cerebral inflammatory disorders must be considered.Downloads
References
Alroughani R, Boyko A. Pediatric Multiple Sclerosis: A Review. BMC Neurol. 2018;18:27. doi:10.1016/j. yapd.2019.03.003
Chou IJ, Wang HS, Whitehouse WP, Constantinescu CS. Paediatric Multiple Sclerosis: Update on Diagnostic Criteria, Imaging, Histopathology and Treatment Choices. Curr Neurol Neurosci Rep. 2016;16. doi:10.1007/s11910-016-0663-4
Sandvig I, Barlinn J, Nedregaard B, Skjeldal OH. Multiple sclerosis in children and adolescents. An important differential diagnosis of acute neurological disease. Eur J Paediatr Neurol. 2015;19:211–217. doi:10.1016/j.ejpn.2014.12.004
Correia AS, Augusto L, Meireles J, Pinto J, Sousa AP. Pediatric Multiple Sclerosis in Portugal: A Multicentre Study. Acta Med Port. 2016;29:425. doi:10.20344/amp.6346
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Ann Neurol. 2011;69:292–302. doi:10.1002/ana.22366
Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162– 73. doi:10.1016/S1474-4422(17)30470-2
Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, Seze J de, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85:177–89. doi:10.1212/ WNL.0000000000001729
Galardi MM, Gaudioso C, Ahmadi S, Evans E, Gilbert L, Mar S. Differential Diagnosis of Pediatric Multiple Sclerosis. Children. 2019;6:75. doi:10.3390/children6060075
Makhani N, Tremlett H. The multiple sclerosis prodrome. Nat Revi Neurol; 21: 515-21. doi:10.1038/s41582-021-00519-3
Forslin Y, Granberg T, Jumah AA, Aspelin P, Kristoffersen-Wiberg M, Martolaet J, et al. Incidence of radiologically isolated syndrome: A population-based study. Am J Neuroradiol. 2016;37:1017–22. doi:10.3174/ajnr.A466010.
Okuda DT, Siva A, Kantarci O, Inglese M, Katz I, Tutuncu M, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9:e90509. doi:10.1371/journal.pone.0090509.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Daniela Araújo, Ângela Pereira, Sofia A. Martins, Ricardo Maré, João Cerqueira, Susana Carvalho
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
